Surgical Tx of Peripheral Vascular Disease
Surgery is used once more conservative treatments like lifestyle modifications have failed to
alleviate the symptoms.
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Angioplasty- this is used for for narrowings in large vessels like the femoral artery.
o Stenting- this can be done along with the angioplasty for recurrent disease
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Atherectomy- excision of plaque using a catheter with a laser or a mechanical shaver.1
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Endarterectomy- the surgical excision of plaque by opening the vessel wall.2
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Sympathectomy – removal of the sympathetic nervous supply to the vessels. This causes the
smooth muscle to relax, causing vasodilatation.
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Bypass grafting- the use of a vein or a synthetic graft to bypass the stenosed region.
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Amputation-if severe ischemia occurs and tissue undergoes necrosis the only option is to
excise the dead tissue by amputating the affected area. Below the knee amputation is more
favourable to above the knee as full mobility is achieved by more pts (70% vs 30%).
http://video.about.com/heartdisease/Atherectomy.htm
http://www.youtube.com/watch?v=ImHe-7RoqVc